both lungs to prevent a further •

Treatment may include insertion

pneumothorax. of a chest tube or aspiration of the
free air in the chest cavity
Returning to work and sport • Your attention is drawn to the
• Normal physical activity does not restrictions on flying and diving
cause a pneumothorax to recur after a pneumothorax
• You may return to work and sport References
when your symptoms have settled
• Activities involving extreme
Based on British Thoracic Society
Guidelines for the Management of
Pneumothorax
exertion or physical contact should Spontaneous Pneumothorax 2003.
be resumed after a chest x-ray has
confirmed full resolution of the Contact details
pneumothorax
Emergency department 01823 342906
Will I get another pneumothorax?
Having one pneumothorax increases
the risk of developing the condition
again. About 40% of patients will
develop another pneumothorax. Most
recurrences occur within one to two
years.

Pneumothorax at a glance
Emergency Department
• A pneumothorax is a collection of
free air in the chest that causes the
lung to collapse
• A small primary pneumothorax may
resolve without treatment; a larger
pneumothorax and ones arising as
a result of lung disease or injury
requires treatment

J Louis /Feb17/review Feb20

What is a pneumothorax?
A pneumothorax (pleural:
pneumothoraces) is a collection of air in
the chest outside the lung that causes
the lung to collapse.
What are the types of pneumothorax?
• A primary pneumothorax occurs in
the absence of an injury to the chest
or a known lung disease. It is caused
by a rupture of a cyst or a small sac
(bleb) on the surface of the lung.
• A secondary pneumothorax occurs as
a result of an underlying condition
such as cystic fibrosis, chronic
obstructive pulmonary disease
(COPD), lung cancer, asthma or
infections of the lungs.
• A traumatic pneumothorax occurs as
the result of injury to the chest such
as a broken rib or stab wound.
Who is at risk of primary
pneumothorax?
Pneumothorax can affect people who
have no history of lung disease. This
type of pneumothorax is most common
in men between the ages of 20 and 40,
particularly in tall, thin men. Smoking
has been shown to increase the risk
for spontaneous pneumothorax. If you
smoke we strongly recommend that you
see your GP or advice on stopping.
What are the signs and symptoms of
pneumothorax?
Symptoms of a pneumothorax include
chest pain that usually has a sudden
onset. The pain is sharp and may lead
to feelings of tightness in the chest.
Shortness of breath, rapid heart rate,
rapid breathing, cough, and fatigue are
other symptoms of pneumothorax.
How is pneumothorax diagnosed?
Examination of the chest with a
stethoscope reveals decreased or absent
breath sounds over the affected lung.
The diagnosis is confirmed by chest x-ray.
How is a pneumothorax treated?
• A small primary pneumothorax may
resolve on its own
• Larger primary pneumothoraces and
a small secondary pneumothoraces
require aspiration of the free air
(sucking it out with a needle and
syringe under local anaesthetic).
If this is successful patients with
primary pneumothorax may be
discharged. Patients with secondary
pneumothoraces will be admitted to
hospital for observation.
• If aspiration in the above cases
fails or there is a large secondary
pneumothorax a chest drainage
tube will be inserted under local
anaesthetic to evacuate the air.
Patients with chest drainage tubes will
need to stay in hospital.
Your doctor will discuss any necessary
treatment with you.
In rare cases, the leak does not close on
its own. This is called a bronchopleural
fistula, and may require chest surgery
to repair the hole in the lung.
Discharge and follow up
Patients with pneumothoraces who
are discharged from the Emergency
Department should be given an
appointment to return for a follow up
chest x-ray after 2 weeks. Please return
to A&E if you experience worsening
shortness of breath.
Flying after pneumothorax
• Patients with spontaneous
pneumothorax should not fly until a
chest x-ray has confirmed resolution
of the pneumothorax.
• Patients with a pneumothorax
following injury should not fly
until two weeks after a chest x-ray
has confirmed resolution of the
pneumothorax.
• As there is a risk of recurrence, and
this may have serious consequences
during flight, those patients with
underlying lung disease may decide
to avoid this risk by avoiding flight
for up to one year.
Diving after pneumothorax
Diving should not be undertaken after
a pneumothorax unless a surgical
procedure has been performed on